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Voyeuristic Disorder
DSM-III In DSM-III, this disorder is called Voyeurism Diagnostic Criteria A'''. The individual repeatedly observes suspecting people who are naked, in the act of disrobing, or engaging in sexual activity and no sexual activity with the observed people is sought. '''B. The observing is the repeatedly preferred or exclusive method of achieving sexual excitement. Differential Diagnosis Normal sexual activity often includes sexual excitement from observing nudity, undressing, or sexual activity. However, it is not with an unsuspecting partner, and it is usually a prelude to further sexual activity. Watching pornography, filmed or live, causes sexual excitement. However, the people who are being observed are willingly in view, even though in fantasy the observer may imagine (but knows better) that the people are unsuspecting. DSM-IV In DSM-IV, this disorder is called Voyeurism For more information, see Paraphilias The paraphiliac focus of Voyeurism involves the act of obsessing unsuspecting individuals, usually strangers, who are naked, in the process of disrobing, or engaging in sexual activity. The act of looking ("peeping") is for the purpose of achieving sexual excitement, and generally no sexual activity with the observed person is sought. Orgasm, usually produced by masturbation, may occur during the voyeuristic activity or later in response to the memory of what the person has witnessed. Often these individuals have the fantasy of having a sexual experience with the observed person, but in reality this rarely occurs. In its severe form, peeping constitutes the exclusive form of sexual activity. The onset of voyeuristic behavior is usually before age 15 years. The course tends to be chronic. Diagnostic Criteria A'''. Over a period of at least 6 months, recurrent, intense sexually arousing fantasies, sexual urges, or behaviors involving the act of observing an unsuspecting person who is naked, in the process of disrobing, or engaging in sexual activity. '''B. The fantasies, sexual urges, or behaviors cause clinically significant distress or impairment in social, occupational, or other important areas of functioning. DSM-5 Diagnostic Criteria A'''. Over a period of at least 6 months, recurrent and intense sexual arousal from observing an unsuspecting person who is naked, in the process of disrobing, or engaging in sexual activity, as manifested by fantasies, urges, or behaviors. '''B. The individual has acted on these sexual urges with a nonconsenting person, or the sexual urges or fantasies cause clinically significant distress or impairment in social, occupational, or other important areas of functioning. C'. The individual experiencing the arousal and/or acting on the urges if at least 18 years of age. ''Specify if: * '''In a controlled environment: This specifier is primarily applicable to individuals living in institutional or other settings where opportunities to engage in voyeuristic behavior are restricted. * In full remission: The individual has not acted on the urges with a nonconsenting person, and there has been no distress or impairment in social, occupational, or other areas of functioning, for at least 5 years while in an uncontrolled environment. Specifiers The "in full remission" specifier does not address the continued presence or absence of voyeurism per se, which may still be present after behaviors and distress have remitted. Differential Diagnosis Conduct disorder and antisocial personality disorder Conduct disorder in adolescents and antisocial personality disorder would be characterized by additional norm-breaking and antisocial behaviors, and the specific sexual interest in secretly watching unsuspecting others who are naked or engaging in sexual activity should be lacking. Substance use disorders Substance use disorders might involve single voyeuristic episodes by intoxicated individuals but should not involve the typical sexual interest in secretly watching unsuspecting persons being naked or engaging in sexual activity. Hence, recurrent voyeuristic sexual fantasies, urges, or behaviors that occur also when the individual is not intoxicated suggest that voyeuristic disorder might be present.